chronic subinvolution of uterus

Chronic Subinvolution of Uterus: A Condition Where the Uterus Fails to Return to Its Pre-Pregnancy Size

Chronic subinvolution of the uterus is a condition where the uterus does not shrink back to its pre-pregnancy size after childbirth, as it normally would. This can lead to various complications and symptoms.

Causes and Risk Factors: The exact cause of chronic subinvolution is often unclear, but it may be related to retained placental tissue or infections. Other risk factors include:

• Previous uterine surgery
• Multiple pregnancies
• Uterine abnormalities

Symptoms:

• Heavy bleeding (postpartum hemorrhage)
• Increased risk of infection
• Abnormal uterine shape and size
• Fertility issues in some cases

Diagnosis: A healthcare provider may order an ultrasound to assess the uterus's size and shape. A physical examination, medical history, and laboratory tests may also be performed to rule out other conditions.

Treatment: Treatment for chronic subinvolution typically involves addressing any underlying causes, such as retained placental tissue or infections. This may include medications, surgical interventions, or other therapies.

Prevention: While the exact cause of chronic subinvolution is often unclear, maintaining good uterine health before and after pregnancy can help prevent this condition. Regular prenatal care, proper postpartum care, and addressing any underlying medical conditions can also reduce the risk of developing chronic subinvolution.

References:

• [1] Subinvolution of the uterus refers to a condition where the uterus does not shrink to its pre-pregnancy size in the expected timeframe after childbirth. Often caused by retained placental tissue or infections, this can lead to heavy bleeding and increased risk of infection. ... Review of uterine subinvolution: definition, risk factors, clinical presentation, diagnosis, treatment, and prevention. [12]
• [2] The uterus is the most common organ affected by subinvolution. As a result, it may feel boggy and softer upon palpation. When the involution is impaired or retarded it is called subinvolution. [11]
• [3] A uterine disease that is characterized by the inability of the uterus to return to its pre-gestational size after pregnancy. [5]
• [4] Chronic uterine inversion with malignancy mimicking carcinoma cervix. BMJ Case Rep. 2019 Feb 01; 12 (2) [PMC free article: PMC6366801] [PubMed: 30709891] 5

Chronic Subinvolution of Uterus: Signs and Symptoms

Chronic subinvolution of the uterus refers to a prolonged or impaired involution process after childbirth, where the uterus fails to return to its normal size and shape. This condition can lead to various signs and symptoms, which are essential to recognize for proper diagnosis and treatment.

Common Signs and Symptoms:

• Prolonged and excessive bleeding: Heavy and prolonged vaginal bleeding is a common symptom of chronic subinvolution (1, 13).
• Boggy uterus: The uterus may feel soft and boggy during physical examination, indicating impaired involution (7, 12).
• Irregular descent of the uterus: The fundus of the uterus may not return to its normal position at the umbilicus, leading to an irregular descent (12).
• Prolonged local discharge: A foul-smelling vaginal discharge can persist for an extended period, indicating chronic subinvolution (13).
• Abdominal pain or discomfort: Women with chronic subinvolution may experience persistent abdominal pain or discomfort (1, 14).

Other Associated Symptoms:

• Fever: Some women may develop fever due to endometritis or other complications associated with chronic subinvolution (10, 12).
• Vaginal bleeding: Vaginal bleeding can be a recurring symptom, especially if the condition is not properly managed (9, 13).

Important Notes:

• Chronic subinvolution of the uterus can lead to various complications, including recurrent secondary postpartum hemorrhages and local uterine tissue coagulopathy (8).
• Early recognition and treatment are crucial to prevent long-term consequences and ensure proper healing.

References:

1. Context result 1
2. Context result 2
3. Context result 3
4. Context result 4
5. Context result 5
6. Context result 6
7. Context result 7
8. Context result 8
9. Context result 9
10. Context result 10
11. Context result 11
12. Context result 12
13. Context result 13
14. Context result 14

Based on the provided context, here are the diagnostic tests for chronic subinvolution of the uterus:

• Physical exam and medical history review: A diagnosis of subinvolution of the uterus is usually made based on a physical exam and a review of the patient's medical history [12].
• Ultrasound: Additional tests, such as an ultrasound, may also be ordered to rule out other potential causes of uterine subinvolution [12].
• Blood work: Blood work may also be ordered to rule out other potential causes of uterine subinvolution [12].

It's worth noting that the diagnosis of chronic subinvolution of the uterus is often made based on a combination of clinical features and histologic findings, rather than a single diagnostic test.

References: [12] - This information was cited from search result 12. [12][12] - The mention of ultrasound and blood work in this answer were also cited from search result 12.

Treatment Options for Chronic Subinvolution of Uterus

Chronic subinvolution of the uterus is a condition where the uterus fails to return to its pre-pregnancy size, leading to prolonged bleeding and other complications. While surgical interventions are often considered, drug treatment can also be an effective option in managing this condition.

Conservative Medical Therapy

According to [6], conservative medical therapy is one of the methods for treating patients with subinvolution of the placental site, which includes chronic subinvolution of the uterus. This approach typically involves the use of uterotonic drugs and other medications to stimulate uterine contractions and promote involution.

Uterotonic Drugs

Uterotonic drugs such as oxytocin, ergometrine, and carbetocin are commonly used to treat subinvolution of the uterus. These medications work by stimulating uterine contractions, which can help to reduce bleeding and promote involution.

Other Medications

In addition to uterotonic drugs, other medications may be prescribed to manage symptoms associated with chronic subinvolution of the uterus, such as pain and infection. For example, [10] mentions that medication, instrumental, and massage procedures are used in the treatment of uterine subinvolution.

Importance of Determining Disease Type

The effectiveness of drug treatment for chronic subinvolution of the uterus depends on determining the type of disease, particularly if it is infectious in nature. According to [10], identifying the pathogen can play an important role in the success of therapeutic measures.

In summary, while surgical interventions are often considered, drug treatment can be an effective option in managing chronic subinvolution of the uterus. Conservative medical therapy, uterotonic drugs, and other medications may be used to stimulate uterine contractions, reduce bleeding, and promote involution.

Differential Diagnosis of Chronic Subinvolution of Uterus

Chronic subinvolution of the uterus, also known as chronic uterine inversion, is a rare condition where the uterus fails to return to its normal size and shape after childbirth. The differential diagnosis for this condition involves identifying other possible causes of the symptoms. Here are some potential differential diagnoses:

• Prolapsed fibroid: A prolapsed fibroid can mimic the symptoms of chronic subinvolution of the uterus, including a feeling of fullness or heaviness in the pelvis.
• Endometritis: Endometritis is an inflammation of the endometrium, which can cause symptoms such as pelvic pain and vaginal bleeding. This condition can be mistaken for chronic subinvolution of the uterus.
• Retained products of placenta: Retained products of placenta refer to any tissue that remains in the uterus after delivery. This can include placental fragments or other debris.
• Gestational trophoblastic disease: Gestational trophoblastic disease is a rare condition where abnormal cells grow in the uterus, leading to symptoms such as vaginal bleeding and pelvic pain.
• Coagulopathy: Coagulopathy refers to a disorder of blood clotting. This can lead to symptoms such as excessive bleeding or bruising.

Key Points

• Chronic subinvolution of the uterus is a rare condition that requires careful differential diagnosis.
• Other conditions, such as prolapsed fibroid, endometritis, retained products of placenta, gestational trophoblastic disease, and coagulopathy, can mimic the symptoms of chronic subinvolution of the uterus.

References

• [4] Uterine inversion is nonpuerperal, occurring as a result of an en dometrial or myometrial mass.
• [6] On examination, the absence of a pelvic uterus was noted, and, on the speculum, an oozing reddish cervical mass, palpation of which notes a tight cervical ring behind the mass.
• [8] The diagnosis of chronic uterine inversion occurs after birth or secondary to pathologies of the uterus.
• [9] Myogenic subtype. Slow involution is mainly due to overgrowth or weakness of the muscles in the uterus.

Note: The references provided are based on the search results within the context.